Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 152 No. 3738 (2022)

Management of injuries in Swiss primary care practices: a cross-sectional study within the Sentinella surveillance system

  • Rolf Bäumlin
  • Christelle Kaiser
  • Christophe Combescure
  • Jörg Rohrer-Christ
  • Lilli Herzig
  • Dagmar M. Haller
Cite this as:
Swiss Med Wkly. 2022;152:w30226


INTRODUCTION: Injuries are amongst the most frequent causes of morbidity and mortality worldwide. Our aim was to describe the frequency, type of injury and care provided in primary care in Switzerland.

METHODS: We used anonymous data from 14,307 injury-related consultations of all ages, with a representative sample of 160 primary care physicians from the Sentinella network throughout the year 2017. Descriptive information about patients presenting with one or multiple injuries and the type of care provided were collected in a weekly questionnaire. Data about the primary care physicians including their experience, postgraduate training, equipment and skills were obtained using a single anonymous questionnaire. Negative binomial regression models with mixed effects were used to examine the association between primary care physicians’ characteristics, the proportion represented by injured patients in their total activity and independent management in primary care (without referral). With these models, the associations are expressed as a ratio of prevalence (PR).

RESULTS: The median proportion (prevalence) of injury-related consultations was 2.0% (range 0.0–19.8%), with a significant difference between paediatricians and general practitioners (median 1.2% vs 2.1%). Nearly 60% of consultations for injuries involved men, 21.0% were for patients <18 years and 15.3% for those above 65. Sprains and dislocations (31.2%) were the most frequent diagnoses followed by cutaneous injuries (23.0%), contusions (20.1%) and fractures (18.8%).  Of the injuries presenting directly to primary care, 87.0% were managed by the primary care physician without referral to external services. Fractures were the main diagnosis motivating referral, yet 67.9% of them were entirely managed within primary care. Multivariable analyses showed that training as a paediatrician and a longer experience in primary care were associated with having a lower prevalence of injury-related consultations (adjusted PR [adjPR] 0.49, 95% confidence interval [CI] 0.31–0.78 and adjPR 0.41, 95% CI 0.23–0.75, respectively), whereas the ability to offer wound care including sutures and both splints and casts were associated with a much higher prevalence of injury-related consultations (adjPR 9.36, 95% CI 3.42–25.61 and adjPR 2.38, 95% CI 1.43–3.97, respectively). 

CONCLUSION: The proportion represented by injured patients in a primary care physician’s total activity is heterogeneous. Most patients with mild to moderate injuries could be managed in primary care without referral to secondary care. Further studies could explore factors associated with patients’ decision to consult their primary care physician or emergency services for injuries. Exploring outcomes of primary care and patients’ satisfaction is another future research priority.


  1. Vos T, Barber RM, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Aug;386(9995):743–800.
  2. Schwab PR, Benneker LM, Eggli S, Zimmermann H, Exadaktylos AK. Outcome and patients’ satisfaction after functional treatment of acute lateral ankle injuries at emergency departments versus family doctor offices. BMC Fam Pract. 2008 Dec;9(1):69.
  3. Britt H. Britt. General practice activity in Australia 1998?1999. N S W Public Health Bull. 1999;10(12):167.
  4. Höglinger M, Knöfler F, Schaumann-von Stosch R, Scholz-Odermatt SM, Eichler K. Recent trends and variations in general practitioners’ involvement in accident care in Switzerland: an analysis of claims data. BMC Fam Pract. 2020 Jun;21(1):99.
  5. Hugentobler W. Kostenvergleich der ambulanten Notfallversorgung in der hausärztlichen Praxis mit den Notfallstationen der Spitäler. Prim Hosp Care. 2006 Aug;6(32):586–9.
  6. Eichler K, Hess S, Chmiel C, Bögli K, Sidler P, Senn O, et al. Sustained health-economic effects after reorganisation of a Swiss hospital emergency centre: a cost comparison study. Emerg Med J. 2014 Oct;31(10):818–23.
  7. Gnädinger M, Herzig L, Ceschi A, Conen D, Staehelin A, Zoller M, et al. Chronic conditions and multimorbidity in a primary care population: a study in the Swiss Sentinel Surveillance Network (Sentinella). Int J Public Health. 2018 Dec;63(9):1017–26.
  8. Gnädinger M, Conen D, Herzig L, Puhan MA, Staehelin A, Zoller M, et al. Medication incidents in primary care medicine: a prospective study in the Swiss Sentinel Surveillance Network (Sentinella). BMJ Open. 2017 Jul;7(7):e013658.
  9. Statistique des accidents [Internet]. [cited 2021 Aug 28]. Available from:
  10. Gafforini S, Turbitt E, Freed GL. Lower urgency paediatric injuries: parent preferences for emergency department or general practitioner care. Emerg Med Australas. 2016 Oct;28(5):564–8.
  11. Zoni AC, Domínguez-Berjón MF, Esteban-Vasallo MD, Regidor E. [Injuries treated in primary care in the Community of Madrid: analyses of electronic medical records]. Gac Sanit. 2014 Jan-Feb;28(1):55–60.
  12. Faul M, Wald MM, Sullivent EE, Sasser SM, Kapil V, Lerner EB, et al. Large cost savings realized from the 2006 Field Triage Guideline: reduction in overtriage in U.S. trauma centers. Prehosp Emerg Care. 2012 Apr-Jun;16(2):222–9.

Most read articles by the same author(s)

1 2 > >>